Provider First Line Business Practice Location Address:
254 FRANKLIN STREET
Provider Second Line Business Practice Location Address:
LAKE SHORE BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-842-0440
Provider Business Practice Location Address Fax Number:
716-842-4069
Provider Enumeration Date:
12/10/2008